Kennedy Marie Wade
Individual provider Active NPI Physical Therapist · Eudora, KS
NPI 1083569495 · NPPES record last updated Mar 2, 2026
Key facts
- NPI
- 1083569495
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11-08110 (KS)
- Practice address
- 218 E 20TH St Ste a
Eudora, KS 66025-7700 - Phone
- (785) 542-3333
- NPI assigned
- Mar 2, 2026
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Serc Rebabilitation Partners, LLC
Practice addresses (Care Compare)
218 E 20TH St
Suite a
Eudora, KS 66025-7700
Phone (785) 542-3333
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260311003947 | KS | Practitioner - Physical Therapist in Private Practice | 0840773438 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-08110 | KS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serc Rebabilitation Partners, LLC | Physical Therapist | Current |
Accepting new patients |
| Serc Rehabilitation Partners, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568
218 E 20th St
Ste A
Eudora, KS 66025
Phone (785) 542-3333
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-08110 | KS | Yes |
Addresses
Primary practice location
218 E 20TH St Ste a
Eudora, KS 66025-7700
Mailing address
1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 702-4389
Other providers in Eudora, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.